浏览全部资源
扫码关注微信
清气化痰丸加减治疗慢性阻塞性肺疾病急性加重期痰热壅肺证的临床疗效及对血清TNF-
α ，IL-8，MMP-9的影响Clinical Efficacy of Modified Qingqi Huatan Wan in Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Syndrome of Phlegm-heat Obstructing Lung and Effect on Serum TNF-α, IL-8 and MMP-9
- 中国实验方剂学杂志 2019年25卷第9期 页码：31-37
- 作者机构：
广西中医药大学 附属瑞康医院，南宁 530011
- 作者简介：
刘锐，博士，副主任医师，从事呼吸及心血管系统疾病的诊治研究， E-mail：dyshuxi@126.com
侯体保，硕士，住院医师，从事呼吸及心血管系统疾病的诊治研究， E-mail：yshoutibao@163.com
- 基金信息：广西自然科学基金青年基金项目(2013GCNSFBA019144);广西壮族自治区卫生厅自筹经费科研课题项目(Z2013248)
DOI：10.13422/j.cnki.syfjx.20182212
中图分类号： R22; R242; R2-031; R287收稿日期：2018-04-30，
网络出版日期：2018-08-28，
纸质出版日期：2019-05-05
- 稿件说明：
移动端阅览
刘锐, 侯体保, 何嘉, 等. 清气化痰丸加减治疗慢性阻塞性肺疾病急性加重期痰热壅肺证的临床疗效及对血清TNF-
α ，IL-8，MMP-9的影响[J]. 中国实验方剂学杂志, 2019,25(9):31-37.Rui LIU, Ti-bao HOU, Jia HE, et al. Clinical Efficacy of Modified Qingqi Huatan Wan in Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Syndrome of Phlegm-heat Obstructing Lung and Effect on Serum TNF-α, IL-8 and MMP-9[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(9): 31-37.
刘锐, 侯体保, 何嘉, 等. 清气化痰丸加减治疗慢性阻塞性肺疾病急性加重期痰热壅肺证的临床疗效及对血清TNF-
α ，IL-8，MMP-9的影响[J]. 中国实验方剂学杂志, 2019,25(9):31-37. DOI： 10.13422/j.cnki.syfjx.20182212.Rui LIU, Ti-bao HOU, Jia HE, et al. Clinical Efficacy of Modified Qingqi Huatan Wan in Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Syndrome of Phlegm-heat Obstructing Lung and Effect on Serum TNF-α, IL-8 and MMP-9[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(9): 31-37. DOI： 10.13422/j.cnki.syfjx.20182212.
摘要
目的：
2
探讨清气化痰丸加减治疗慢性阻塞性肺疾病急性加重期痰热壅肺证的临床疗效及对患者血清肿瘤坏死因子-
α
(tumor necrosis factor-alpha
TNF-
α
)，白细胞介素-8(interleukin-8，IL-8)和基质金属蛋白酶-9(matrix metalloproteinase-9，MMP-9)的影响。
方法：
2
将64例患者按随机数字表法，分为对照组与治疗组，各32例，对照组根据指南和患者病情变化给予西医常规治疗，治疗组在对照组基础上加服清气化痰丸加减治疗，疗程均为14 d。比较两组患者治疗前后中医证候积分，慢性阻塞性肺疾病患者自我评估测试问卷(CAT)和改良版英国医学研究委员会呼吸问卷(mMRC)，肺功能及血气分析指标，血清TNF-
α
，IL-8，MMP-9水平，临床疗效和安全性指标，以上指标治疗前及治疗14 d后各评价1次。
结果：
2
对照组临床疗效总有效率为76.67%，治疗组为96.67%，治疗组临床总有效率均明显高于对照组(
χ
2
＝5.192，
P
<
0.05)。两组治疗后中医证候积分，CAT和mMRC与本组治疗前比较均明显降低(
P
<
0.05)；且治疗组均明显低于对照组(
P
<
0.05)。两组治疗后第1秒用力呼气容积(FEV
1
)，第1秒用力呼气容积占预计值百分比(FEV
1
%)，第1秒用力呼气容积占用力肺活量的百分比(FEV
1
/FVC)较本组治疗前均明显升高(
P
<
0.05)；且治疗组明显高于对照组(
P
<
0.05)。两组治疗后血氧饱和度(SaO
2
)，血氧分压(PaO
2
)较本组治疗前均有升高，二氧化碳分压(PaCO
2
)明显降低(
P
<
0.05)；且治疗组SaO
2
，PaO
2
均明显高于对照组，PaCO
2
明显低于对照组(
P
<
0.05)。两组治疗后血清TNF-
α
，IL-8和MMP-9水平较本组治疗前均明显降低(
P
<
0.05)；且治疗组明显低于对照组(
P
<
0.05)。
结论：
2
清气化痰丸加减治疗慢性阻塞性肺疾病急性加重期痰热壅肺证疗效确切且安全，能够改善患者临床症状和肺功能，降低患者血清中TNF-
α
，IL-8和MMP-9水平，减轻炎症。
Abstract
Objective:
2
To explore the clinical efficacy of modified Qingqi Huatan Wan in treatment of acute exacerbation of chronic obstructive pulmonary disease (syndrome of phlegm-heat obstructing lung) and investigate its effects on serum tumor necrosis factor-alpha (TNF-
α
)
interleukin-8 (IL-8) and matrix metalloproteinase-9 (MMP-9).
Method:
2
Sixty-four patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) were randomly divided into control group (32 cases) and treatment group(32 cases) by random number table.The control group was treated with routine western medicine therapy according to the guidance and disease conditions. Based on treatment in control group
patients in treatment group also received modified Qingqi Huatan Wan. The treatment course was 14 days for both groups.The scores of traditional Chinese medicine (TCM) syndrome
chronic obstructive pulmonary disease (COPD) assessment test (CAT)
and modified version of the British Medical Research Council's Respiratory Questionnaire (mMRC)
pulmonary function
blood gas analysis indicators
levels of serum TNF-
α
IL-8 and MMP-9
clinical efficacy and safety were evaluated and compared once before treatment and 14 d after treatment.
Result:
2
The total clinical effective rate was 96.67% in treatment group
higher than 76.67% in control group (
χ
2
= 5.192
P
<
0.05). After treatment
scores of TCM syndrome
CAT and mMRC were reduced in both groups (
P
<
0.05)
and the scores in treatment group were all lower than those in control group (
P
<
0.05). Levels of forced expiratory volume in one second (FEV
1
)
percent of FEV
1
in predicted value (FEV
1
%)
and ratio of FEV
1
to forced vital capacity (FEV
1
/FVC) were increased in both groups after treatment (
P
<
0.05)
and the above levels in treatment group were higher than those in control group (
P
<
0.05). After treatment
oxygen saturation (SaO
2
) and partial pressure of oxygen (PaO
2
) were increased in both groups
while partial pressure of carbon dioxide (PaCO
2
) was decreased (
P
<
0.05)
and SaO
2
and PaO
2
in treatment group were higher than those in control group
while PaCO
2
was lower than that in control group (
P
<
0.05). After treatment
serum TNF-
α
IL-8 and MMP-9 were decreased in both groups (
P
<
0.05)
and the levels in treatment group were lower than those in control group (
P
<
0.05).
Conclusion:
2
Modified Qingqi Huatan Wan can control the symptoms safely and ameliorate pulmonary function
reduce the levels of serum TNF-
α
IL-8
MMP-9 and inflammation in treatment of AECOPD.
关键词
Keywords
references
Rodriguez-Roisin R , Rabe K F , Vestbo J , et al . Global Initiative for Chronic Obstructive Lung Disease (GOLD) 20th Anniversary: a brief history of time [J]. Eur Respir J , 2017 , 50 ( 1 ): 1700671 .
Vestbo J , Hurd S S , Agusti A G , et al . Global strategy for the diag-nosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary [J]. Am J Respir Crit Care Med , 2013 , 187 ( 4 ): 347 - 365 .
Miravitl M , Soler J , Calle M , et al . Treatment of COPD by clinical phenotypes: putting old evidence into clinical practice [J]. Eur Respir J , 2013 , 41 ( 6 ): 1252 - 1256 .
HUANG A X , LU L W , LIU W J , et al . Plasma inflammatory cytokine IL-4, IL-8, IL-10, and TNF- α levels correlate with pulmonary function in patients with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome [J]. Med Sci Monit , 2016 , 22 ( 9 ): 2800 - 2808 .
王林梅 ， 齐景宪 ， 冯青青 ． 慢性阻塞性肺疾病急性加重期和稳定期患者血清IL-8、TNF- α 及免疫因子的检测 [J]. 郑州大学学报：医学版 ， 2018 , 53 ( 2 ): 255 - 258 .
吴珂 ， 尚立芝 ， 谢文英 ， 等 ． 二陈汤加味对慢性阻塞性肺疾病细支气管壁细胞外基质重塑的影响 [J]. 中国实验方剂学杂志 ， 2018 , 24 ( 14 ): 122 - 127 .
谢文英 ， 司春婴 ， 尚立芝 ． 爱罗咳喘宁对老年COPD急性加重期痰湿阻肺证患者血清中细胞因子IL-4，IL-8，TNF- α 及肺功能的影响 [J]. 中国实验方剂学杂志 ， 2015 , 21 ( 12 ): 143 - 146 .
王至婉 ， 李建生 ， 余学庆 ， 等 ． 慢性阻塞性肺疾病急性加重期证候及特征的临床调查研究 [J]. 中华中医药杂志 ， 2010 , 25 ( 4 ): 504 - 509 .
王胜 ， 叶海勇 ， 陈悦 ， 等 ． 302例慢性阻塞性肺疾病急性加重期中医证候分型 [J]. 北京中医药大学学报 ， 2015 , 38 ( 1 ): 57 - 62 .
纪曙光 ， 马东梅 ， 崔华英 ， 等 ． 清气化痰丸联合雾化吸入治疗痰瘀互结型慢性阻塞性肺疾病的临床观察 [J]. 中药药理与临床 ， 2017 , 33 ( 2 ): 179 - 182 .
慢性阻塞性肺疾病急性加重(AECOPD)诊治专家组 ． 慢性阻塞性肺疾病急性加重(AECOPD)诊治中国专家共识(2014年修订版) [J]. 国际呼吸杂志 ， 2014 , 34 ( 1 ): 1 - 11 .
中华医学会呼吸病学分会慢性阻塞性肺疾病学组 ． 慢性阻塞性肺疾病诊治指南(2013年修订版) [J]. 中华结核和呼吸杂志 ， 2013 , 36 ( 4 ): 255 - 264 .
中华中医药学会内科分会肺系病专业委员会 ． 慢性阻塞性肺疾病中医证候诊断标准(2011版) [J]. 中医杂志 ， 2012 , 53 ( 2 ): 177 - 178 .
中华人民共和国卫生部 ． 中药新药临床研究指导原则 [M]． 北京 ： 中国医药科技出版社 ， 2002 ： 54 - 58 .
Jones P W , Harding G , Wiklund L , et al . Improving the processand outcome of care in COPD: development of a standardised as-sessment tool [J]. Prim Care respir J , 2009 , 18 ( 4 ): 208 - 215 .
Moermans C , Heinen V , Nguyen M , et al . Local and systemic cellu-lar inflammation and cytokine release in chronic obstructive pulmo-nary disease [J]. Cytokine , 2011 , 56 ( 2 ): 298 - 304 .
Ashitani J . Elevated plasma procoagulant and fibrinolytic markers in patients with chronic obstructive pulmonary disease [J]. Intern Med , 2002 , 41 ( 3 ): 181 - 185 .
王萍 ， 黄献平 ， 王丽萍 ， 等 ． 血栓前状态分子与冠心病血瘀证的相关性研究 [J]. 湖南中医药大学学报 ， 2013 , 33 ( 3 ): 9 - 11,26 .
张玉溪 ． 芩丹汤对慢性阻塞性肺疾病急性加重期患者血清炎性因子及血浆纤维蛋白原的影响 [J]. 中国实验方剂学杂志 ， 2016 , 22 ( 12 ): 172 - 176 .
詹琤琤 ． 清气化痰丸对慢性支气管炎小鼠的治疗研究 [J]. 北方药学 ， 2015 , 12 ( 1 ): 110 .
安畅 ， 张颖 ， 马阮昕 ， 等 ． 半夏有效成分大黄酚对肿瘤坏死因子- α 诱导人脑微血管内皮细胞的作用机制 [J]. 中国实验方剂学杂志 ， 2018 , 24 ( 3 ): 160 - 165 .
Lee I K , KANG K A , ZHANG R , et al . Mitochondria protection of baicalein against oxidative damage via induction of manganese superoxide dismutase [J]. Environ Toxicol Pharmacol , 2011 , 31 ( 1 ): 233 - 241 .
李树铁 ， 汪业铭 ， 李媛莉 ， 等 ． 丹参多酚酸盐治疗慢性阻塞性肺疾病急性加重期的临床观察 [J]. 中国药房 ， 2016 , 27 ( 17 ): 2402 - 2404 .
王春玲 ． 中药地龙的活性成分与药理作用研究 [J]. 亚太传统医药 ， 2015 , 11 ( 7 ): 53 - 54 .
Lee S D , HUANG M S , KANG J , et al . Investigators of the Predictive Ability of CAT in Acute Exacerbations of COPD(PACE) Study. The COPD assessment test (CAT) assists prediction of COPD exacerbations in high-risk patients [J]. Respir Med , 2014 , 108 ( 4 ): 600 - 608 .
Hayata A , Minakata Y , Matsunaga K , et al . Differences in physical activity according to mMRC grade in patients with COPD [J]. Int J Chron Obstruct Pulmon Dis , 2016 , 13 ( 11 ): 2203 - 2208 .
Gershon A , Mecredy G , Croxford R , et al . Outcomes of patients with chronic obstructive pulmonary disease diagnosed with or without pulmonary function testing [J]. CMAJ , 2017 , 189 ( 14 ): E530 - E538 .
Barnes P J . Inflammatory mechanisms in patients with chronic obstructive pulmonary disease [J]. J Allergy Clin Immunol , 2016 , 138 ( 1 ): 16 - 27 .
雷小婷 ， 孟泳 ， 赵润杨 ， 等 ． 无创正压通气治疗慢性阻塞性肺疾病并发感染性肺炎的临床效果及对血清MMP-9与TNF- α 和IL-8的影响 [J]. 中华医院感染学杂志 ， 2018 , 28 ( 7 ): 998 - 1001 .
马蕴蕾 ， 宿英豪 ， 于向艳 ． 补肾益肺化纤方治疗慢性阻塞性肺疾病稳定期合并肺纤维化疗效及对患者肺功能及生活质量的影响 [J]. 中国实验方剂学杂志 ， 2018 , 24 ( 11 ): 168 - 172 .
余苏云 ， 高习文 ， 颜志军 ， 等 ． 肿瘤坏死因子- α -308基因多态性与慢性阻塞性肺疾病急性加重表型的相关性研究 [J]. 中华结核和呼吸杂志 ， 2016 , 39 ( 3 ): 203 - 207 .
Bradford E , Jacobson S , Varasteh J , et al . The value of blood cytokines and chemokines in assessing COPD [J]. Respir Res , 2017 , 18 ( 1 ): 180 .
Anzalone G , Gagliardo R . IL-17A induces chromatin remodeling promoting IL-8 release in bronchial epithelial cells: effect of Tiotropium [J]. Life Sci , 2016 , 152 ( 10 ): 107 - 116 .
ZHANG Y , NI H J , ZHOU H S . Study on the expression of Toll-like receptor 4 and matrix metalloproteinase-9 in patients with chronic obstructive pulmonary disease and their clinical significance [J]. Eur Rev Med Pharmacol Sci , 2017 , 21 ( 9 ): 2185 - 2191 .
潘娜 ， 陈乾华 ， 辛丽云 ， 等 ． 痰上清液MMP-9、TIMP-1与慢性阻塞性肺疾病气道炎症的关系 [J]. 中国老年学杂志 ， 2017 , 37 ( 9 ): 2221 - 2223 .
0
浏览量
12
下载量
3
CSCD
- 网络PDF下载
- BibTeX下载
- Endnote下载
- RefMan 下载
- NoteExpress下载
- NoteFirst下载
关联资源
相关文章
相关作者
相关机构
AI问答- 地址：北京市东城区东直门内南小街16号 邮编：100700
- 联系电话：010-84076882 Email：syfjx_2010@188.com
- 技术支持由北京北大方正电子有限公司提供 京ICP备11006657号-10
京公网安备11010802024621 - 本系统建议在Chrome、 IE9+ 以上版本浏览器阅读本站内容，360浏览器请切换至极速模式
- Cookies帮助我们提供服务并提供个性化体验。使用本网站，即表示您同意我们使用Cookies
